From the category archives:

Wound Dressings

Wound Dressings: Film Dressings

by lswezey on June 16, 2009

Many health care professionals use transparent dressings on a frequent basis, but may not be aware of the purpose of these dressings. In fact, these dressings are not meant for all wounds. Read on to discover everything you ever needed to know about transparent film dressings.

Product Overview

Transparent film dressings are thin dressings which have no ability to absorb fluids. They act as a “second skin”. Imitating your outermost skin layer, they keep a moist wound environment, similar to a blister. They are semi-permeable to gases and have the ability to transmit moisture vapour. These types of dressings permit the migration of epithelial cells over the wound surface. Fluid often accumulates under these dressings.

Indications

  • can be used on stage 1 and 2 pressure ulcers
  • superficial wounds
  • lacerations, or to cover sutured wounds
  • minor burns
  • to protect catheter sites and donor sites
  • superficial dermal ulcers
  • can be used to protect against friction

Contraindications

  • must be applied to healthy skin, not to aging or fragile skin
  • not recommended for infants or small children
  • do not use on exudating wounds
  • do not use for infected wounds

Advantages

  • a cleaner wound surface is created as the accumulation of fluid under the dressing creates an autoloytic environment
  • an excellent protective barrier against surface contaminants, bacteria and fluid
  • provides protection from friction
  • aids in pain control
  • aids in autolytic debridement
  • can be used as a secondary dressing
  • can be left on for up to 7 days
  • numerous shapes and sizes are available to fit a wide variety of wounds

Disadvantages

  • fluid which accumulates under the dressing is sometimes mistakenly identified as pus
  • the dressing needs to be changed when fluid accumulates excessively or leaks out the side of the dressing
  • maceration of the skin around the wound (periwound) may occur if the dressing is not changed when it should be

When removing the dressing, care must be taken to ensure that you don’t tear or damage the skin. To remove, lift the corner of the dressing and pull the film outwards to the edges of the wound to break the barrier. It is important to support the surrounding skin during dressing removal.
In addition, some prefer to use skin protective sprays or wipes on the periwound area before application of the dressing. These help to keep the dressing edges from rolling.

Perhaps reading the last few articles regarding wound dressings has made you realize that there are many things you aren’t aware of when it comes to managing wounds in your client population. If so, we will be continuing our series on types of dressings over the next couple of months. If you would like to become truly expert in caring for your clients’ wounds, you may consider becoming certified in wound care management. For more information, visit www.woundeducators.com to find out how you can start today.

Source:
Baronoski, S & Ayello, E. Wound care essentials: Practice principles (2003). Edition: illustrated, Lippincott Williams & Wilkins.

 

Wound Dressings: Contact Layers

by lswezey on June 10, 2009

Contact layer dressings come in many sizes and configurations from many different manufacturers, making it hard to choose between them. They do, however, share many similar characteristics. The following can be used as a guide for the use of contact layer dressings.

Product Overview

Contact layer dressings consist of a single layer. They may be woven or unwoven, and their main purpose is to protect the wound bed, specifically the fragile tissues of the wound bed. They may be perforated or permeable, and allow exudate (drainage) to pass through to a secondary dressing. Contact layer dressings are nonadherent and are usually very thin.

Indications

  • Should be used on clean wounds that do not contain necrotic tissue
  • May be used as the only (primary) dressing for partial and full-thickness wounds
  • Can be used on donor sites, split thickness skin grafts

Contraindications

  • Should not be used on third-degree burns
  • Not recommended for shallow or small wounds
  • Should not be used for tunneling wounds
  • Should not be used with wounds draining very thick exudate (will not pass through to the secondary dressing)

Advantages

  • Protects new, fragile tissue from trauma
  • Allows passage of exudate away from the wound bed, can be used on wounds with light, moderate, and heavy exudate
  • May be left on the wound for up to a week, so that only the secondary dressing is changed
  • Can be used with topical medications
  • Can be used with gauze dressings
  • Conform to the wound shape

Disadvantages

Require a secondary dressing that may need frequent changing due to exudate, which may not be cost effective or efficient in terms of materials and labour (i.e. gauze dressings)

contact layer
Are you like many other health care professionals who have difficulty deciding which type of dressing to apply to their client’s wound? To learn more about wound care management, or to become certified as a wound care specialist, visit www.woundeducators.com. We’ll make deciding on a wound care plan of treatment for your client an easy choice!

Sources:

Cynthia A. (2005). So, what do I put on this wound? Wound dressing puzzle: Part 1, Dermatology Nursing, 17(2), pg. 143-144

Wound Dressings

by lswezey on June 2, 2009

“You can’t teach an old dog new tricks”. How often have we heard this saying and never thought of it as applying to ourselves? All of us can be guilty of clinging to the old and familiar at times, and wound care is no exception. Are you still attached (pardon the pun) to old ways of dressing wounds, simply because that’s the way you’ve always done things? If this applies to you, our new series of articles will provide you with an overview of all of the “new” dressings available, and when and why they should be used. It’s time to bid a fond farewell to our old friend, the traditional dressing.

 

Older is Not Always Better

Traditional dressings, which usually refer to gauze dressings and sometimes the application of an ointment, are quickly becoming a thing of the past, as today’s emphasis on evidence-based practice has shown these dressings to be inefficient and costly in terms of labour. Gauze dressings require frequent changing, or at least frequent remoistening, and are not cost-effective in today’s climate of cost efficiency.

Not only are they not cost-efficient, but they are not particularly effective in terms of healing, either. Ovington (2001) points out that gauze dressings, even wet-to-dry gauze dressings, cause tissue debridement, but often of healthy tissue as well. This can lead to increased pain, delayed healing, and risk of infection for the patient; thus, wet-to-dry dressings are no longer acceptable practice.

Several agents commonly used to treat wounds in the past have now become more and more obsolete, as evidence shows hem to be more harmful than helpful. Old standards, such as Betadine and peroxide, lead the pack. The Agency for Health Care Research and Policy (2008) states, “Do not use povidone iodine, iodophor, sodium hypochlorite solution, hydrogen peroxide and acetic acid as they have been shown to be cytotoxic”. These agents may add to your patient’s discomfort and may delay healing.

 

The New Guard- Advanced Dressings

What can the new generation of dressings do that the old dressings can’t? You may think of the new dressings as “specialists”, each tackling specific areas of wound healing, such as:

Ÿ  Absorbing exudate

Ÿ  Maintaining hydration

Ÿ  Donating moisture

Ÿ  Addressing the biochemical wound environment

 

However, the most important precept of wound care has not changed: moist wound healing is still the gold standard. Research has been able to show that keeping wounds moist increases rates of healing, reduces patient discomfort, decreases rates of infection, improves cosmesis, and reduces associated costs.

 

Over the next several weeks, we will examine the “next generation” of advanced wound dressings, paying particular attention to indications and contraindications, as well as advantages and disadvantages of each dressing.

 

If you would like to know more about becoming a wound care management specialist, please visit www.woundeducators.com for more information.

 

References:

Ovington, L. (2007). Advances in wound dressings. Clinics in Dermatology, 25, pg. 33-38.

{ 1 comment }

Newer Entries →